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Background: Dementia is becoming a significant public health concern, affecting approximately 130,000 individuals in Austria, whereby nearly 40% of the cases are attributed to modifiable risk factors. Multidomain lifestyle interventions have thereby demonstrated significant effects in reducing the risk of dementia. Objectives: The goal was to define an interoperability framework to conduct standardized monitoring in clinical trials for enhancing dementia risk mitigation. In addition, the identified standards should be integrated into the components of the project. Methods: A step-by-step approach was used, where initially data collection, aggregation and harmonization was carried out with retrospective data from various clinical centers. Afterwards, the interoperability framework was defined including the prospective data that is gathered during a clinical trial. Results: A guideline for integrating healthcare standards was developed and incorporated into the technical components for the clinical trial. Conclusion: The interoperability framework was designed in a scalable way and will be regularly updated for future needs. [ABSTRACT FROM AUTHOR]

Background: Besides microsurgical resection, radiosurgery has been established as the primary treatment option for many patients with brain metastases (BM) in recent years. For the first time, we report on the radiosurgical treatment of a patient with a brain metastasis from a ghost cell carcinoma of the mouth. Case description: We report on a 56 year old male patient with a salivary ghost cell carcinoma of the mouth. Lymph node and pulmonary metastases were present. Thirty-four months after initial diagnosis of the primary tumor, the patient noticed difficulties with tying his shoes and a gait disturbance due to a weakness of his left leg. Consequently, a BM was diagnosed and treated by Gamma Knife radiosurgery (GKRS) with a marginal dose of 16Gy at the 50% isodose line. At 3- and 6-month follow-up after GKRS, the radiated BM was significantly reduced in tumor volume and showed almost no surrounding edema. In addition, at 6-month follow-up, the patient was completely free of neurological symptoms. Two months later, the patient suffered from a severe clinical deterioration, including acute kidney failure and seizures. Imaging showed oncological disease progression in the liver and potential progression of the radiated BM in comparison to the last follow-up MRI. The patient succumbed to his disease in the same month, 43 months after initial tumor diagnosis. Conclusion: Radiosurgery for a BM of a ghost cell carcinoma seems to be an effective treatment option. A slightly higher prescription dose than 16Gy might be advisable. [ABSTRACT FROM AUTHOR]

Objective: Since the publication of A Randomized Trial of Unruptured Brain AVMs (ARUBA), the management of unruptured brain arteriovenous malformations (bAVMs) has been controversially discussed. Long-term follow-up data on the exclusively conservative management of unruptured bAVMs are scarce. The authors evaluated the long-term outcomes of patients with unruptured untreated bAVMs in a real-life cohort., Methods: A retrospective observational cohort of 107 patients (of 897 bAVM patients referred to the authors' institution) with a diagnosis of unruptured and conservatively managed bAVMs is presented. AVMs of all Spetzler-Martin grades were observed. The mean follow-up period was 84 months. In 44% of patients, a follow-up period of 5 years or longer was observed. A national death register comparison completed the outcome analysis., Results: The median age at diagnosis, sex distribution, neurological presentation, and modified Rankin Scale score were comparable to the patients in the medical management arm of the ARUBA study. Patients were mainly young, predominantly male, and in good clinical condition. Similar to the ARUBA cohort, 77% of this study's cohort presented in an excellent clinical status at the time of last follow-up. However, 17% of patients had at least one hemorrhage, resulting in an overall annual hemorrhage risk of 2.7% in the observation period. Moreover, the cumulative 1-, 5-, and 10-year overall hemorrhage rates were 3.0%, 11.3%, and 15.3%, respectively. Consequently, the long-term follow-up AVM-related mortality rate amounted to 8%. The estimated median overall survival after AVM diagnosis was 19.3 years (95% CI 14.0-24.6 years). A multivariate Cox regression model revealed temporal and deep-seated localization as an independent risk factor for AVM hemorrhage, while the presence of seizures reached borderline significance as a risk factor., Conclusions: The authors' results represent the long-term course of unruptured untreated bAVMs. Their data support the conclusion that even in the post-ARUBA era, tailored active treatment options may be offered to patients with unruptured bAVMs. For patient counseling, individual risk factors should be weighed against the center's treatment-specific risks.